TDM

Question 1

Highest concentration of drug in the blood; occurs when absorption/distribution exceeds metabolism/excretion

Answer 1

Peak

Question 2

Lowest concentration of drug in the blood; achieved just before the next dose

Answer 2

Trough

Question 3

Time required for drug concentration to decrease by half

Answer 3

Half-life

Question 4

State where drug absorption/distribution equals metabolism/excretion, typically after 5-7 half-lives

Answer 4

Steady state

Question 5

Lowest drug concentration in the blood that produces adverse response

Answer 5

MTC (Minimum Toxic Concentration)

Question 6

Lowest drug concentration in the blood that produces desired effect

Answer 6

MEC (Minimum Effective Concentration)

Question 7

Range between MEC and MTC that produces therapeutic effect

Answer 7

Therapeutic range

Question 8

Drug dose that produces beneficial effect in 50% of the population

Answer 8

ED50 (Effective Dose 50)

Question 9

Drug dose that produces adverse effect in 50% of the population

Answer 9

TD50 (Toxic Dose 50)

Question 10

Drug dose that causes death in 50% of individuals

Answer 10

LD50 (Lethal Dose 50)

Question 11

Therapeutic index is the ratio that indicates drug safety margin

Answer 11

TD50 to ED50

Question 12

Analytical technique that uses Rf values for semi-quantitative screening

Answer 12

Thin-layer Chromatography

Question 13

Formula for Rf

Answer 13

distance migrated by sample component/distance migrated by solvent

Question 14

Technique for insufficiently volatile and thermolabile compounds; mobile phase is liquid passed over stationary phase in the column

Answer 14

Liquid Chromatography

Question 15

Type of liquid chromatography with liquid mobile phase and stationary phase in a column

Answer 15

HPLC (High-Performance Liquid Chromatography)

Question 16

Liquid chromatography with polar stationary phase and nonpolar mobile phase

Answer 16

Normal-phase LC

Question 17

Liquid chromatography with nonpolar stationary phase and polar mobile phase

Answer 17

Reverse-phase LC

Question 18

Chromatography method for volatile or easily volatile compounds, including organic molecules and many drugs

Answer 18

Gas Chromatography

Question 19

Time it takes for a compound to elute; used for solute identification

Answer 19

Retention time

Question 20

Measurement proportional to the amount of solute present; used for quantification

Answer 20

Peak area or Height

Question 21

Common detector system in GC or HPLC for solute identification and quantification

Answer 21

Mass spectrometry

Question 22

Immunoassay using microparticles as solid phase, enzyme label, and fluorogenic substrate; heterogeneous assay

Answer 22

Microparticle enzyme immunoassay (MEIA)

Question 23

Homogenous immunoassay where enzyme activity as a label is inhibited by antibody binding to antigen-enzyme conjugate

Answer 23

Enzyme-multiplied immunoassay technique (EMIT)

Question 24

Homogenous immunoassay using polarized light; rate of rotation is inversely proportional to polarization degree and analyte concentration

Answer 24

Fluorescence polarization immunoassay (FPIA)

Question 25

Drug activity or fate in the body, influenced by absorption, distribution, metabolism, and excretion

Answer 25

Pharmacokinetics

Question 26

Biochemical and physiological effects of drugs and mechanisms of action, including receptor binding

Answer 26

Pharmacodynamics

Question 27

Measure: Amount of drug absorbed relative to the quantity given; affected by first-pass metabolism

Answer 27

Bioavailability

Question 28

Factor affecting absorption of orally administered drugs through the GI tract

Answer 28

Bioavailability and first-pass metabolism

Question 29

Factor determining drug distribution into interstitial and intracellular spaces

Answer 29

Lipid solubility of the drug

Question 30

Primary site and enzyme system for drug metabolism

Answer 30

Hepatic microsomes via cytochrome P450 system

Question 31

Methods of drug excretion

Answer 31

Hepatic or renal clearance, or a combination

Question 32

Requirement before drug sampling for accurate analysis

Answer 32

Steady state (5-7 half-lives)

Question 33

Specimen type preferred for most drug assays

Answer 33

Serum

Question 34

Specimen type suitable for most drugs except Lithium and free drug assays

Answer 34

Heparinized plasma

Question 35

Reason SST and PST tubes may falsely decrease TCA and anti-arrhythmics

Answer 35

Drug absorption by the gel

Question 36

Specimen type appropriate for immunosuppressant drugs

Answer 36

EDTA whole blood

Question 37

Specimen type for aspirin determination via impedance method

Answer 37

Hirudin (from leech)

Question 38

Time for collecting trough specimens

Answer 38

Before the next dose is administered

Question 39

Sampling guideline when drug toxicity is suspected

Answer 39

STAT sampling

Question 40

Cardioactive drugs for treating CHF

Answer 40

Digoxin

Question 41

Mechanism of action for digoxin

Answer 41

Inhibits Na+-K+-ATPase, decreasing intracellular K+ and increasing intracellular Ca2+ for improved cardiac contraction

Question 42

Lidocaine, Quinidine, Disopyramide, Procainamide class of TDM

Answer 42

Class I antiarrhythmic drugs (Sodium channel blockers)

Question 43

Metabolite of Lidocaine that enhances toxicity

Answer 43

Monoethylglycinexylidide (MEGX)

Question 44

Metabolite of Procainamide with the same physiologic effect as the parent drug

Answer 44

N-acetylprocainamide (NAPA)

Question 45

Propranolol is an example of

Answer 45

Class II antiarrhythmic drugs (Beta blockers)

Question 46

Amiodarone is an example of

Answer 46

Class III antiarrhythmic drugs (Potassium channel blockers)

Question 47

Inactive form of phenobarbital

Answer 47

Primidone

Question 48

Antiepileptic for petit mal/absence seizures

Answer 48

Ethosuximide, Valproic acid (Depakote)

Question 49

New generation anticonvulsants

Answer 49

Tiagabine, Vigabatrin, Gabapentin, Topiramate, Felbamate

Question 50

Bronchodilator used for asthma and COPD

Answer 50

Theophylline

Question 51

Minor metabolite of theophylline; treatment for neonatal apnea

Answer 51

Caffeine

Question 52

Neuroleptics (major tranquilizers) for schizophrenia

Answer 52

Phenothiazines (chlorpromazine), Butyrophenones (haloperidol), Newer drugs (risperidone, olanzapine, quetiapine, aripiprazole)

Question 53

Antimanic agent for bipolar disorder

Answer 53

Lithium

Question 54

Tricyclic antidepressants

Answer 54

Amitriptyline, Imipramine, Doxepin

Question 55

Selective serotonin reuptake inhibitors (SSRIs)

Answer 55

Fluoxetine (Prozac)

Question 56

Monoamine oxidase inhibitors (MAOIs)

Answer 56

Clorgyline, Selegiline

Question 57

Antibiotics used for gram-negative bacterial infections; causes nephrotoxicity and ototoxicity (TOGAK)

Answer 57

Aminoglycosides (tobramycin, gentamicin, amikacin, kanamycin)

Question 58

Used for gram-positive bacterial infections; may cause Red Man Syndrome (erythemic flushing of extremities)

Answer 58

Vancomycin

Question 59

Immunosuppressants: Block T lymphocyte function

Answer 59

Calcineurin inhibitors (Cyclosporine fat soluble; Tacrolimus is 100x more potent than Cyclosporine and associated with thrombus formation)

Question 60

Immunosuppresant that is proliferation signal inhibitors

Answer 60

Sirolimus (Rapamycin), Everolimus, Mycophenolate, Leflunomide

Question 61

Antineoplastic: Inhibits DNA synthesis; requires Leucovorin administration to rescue host cells

Answer 61

Methotrexate

Question 62

Antineoplastic: alkylating agent used to treat leukemias and lymphomas before bone marrow transplantation

Answer 62

Busulfan

Question 63

Verapamil is an example of

Answer 63

Class IV antiarrhythmic drugs (Calcium channel blockers)

Question 64

Treatment for tachyarrhythmias

Answer 64

Antiarrhythmics

Question 65

First-generation anticonvulsants for grand mal/tonic-clonic seizure

Answer 65

Phenobarbital